1.The efficacy and safety of radiofrequency ablation in papillary thyroid carcinoma: A systematic review and meta-analysis.
Wei Shuen Clarissa CHEONG ; Xin Yi Joy AU ; Ming Yann LIM ; Ernest Weizhong FU ; Hao LI ; Uei PUA ; Yong Quan Alvin SOON ; Yijin Jereme GAN
Annals of the Academy of Medicine, Singapore 2025;54(3):170-177
INTRODUCTION:
Radiofrequency ablation (RFA) avoids the complications of general anaesthesia, reduces length of hospitalisation and reduces morbidity from surgery. As such, it is a strong alternative treatment for patients with comorbidities who are not surgical candidates. However, to our knowledge, there have only been 1 systematic review and 3 combined systematic review and meta-analyses on this topic to date. This systematic review and meta-analysis seeks to evaluate the efficacy and safety of RFA in the treatment of papillary thyroid carcinoma (PTC) with longer follow-up durations.
METHOD:
PubMed, Embase and Cochrane databases were searched for relevant studies published from 1990 to 2021; 13 studies with a total of 1366 patients were included. The Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines and Sandelowski et al.'s approach1 to "negotiated consensual validation" were used to achieve consensus on the final list of articles to be included. All authors then assessed each study using a rating scheme modified from the Oxford Centre for Evidence-Based Medicine.
RESULTS:
Pooled volume reduction rates (VRRs) from 1 to 48 months after RFA, complete disappearance rates (CDR) and complications were assessed. Pooled mean VRRs were 96.59 (95% confidence interval [CI] 91.05-102.13, I2=0%) at 12 months2-6 and 99.31 (95% CI 93.74-104.88, I2=not applicable) at 48 months.2,5 Five studies showed an eventual CDR of 100%.2,4,7-9 No life-threatening complications were recorded. The most common complications included pain, transient voice hoarseness, fever and less commonly, first-degree burn.
CONCLUSION
RFA may be an effective and safe alternative to treating PTC. Larger clinical trials with longer follow-up are needed to further evaluate the effectiveness of RFA in treating PTC.
Humans
;
Radiofrequency Ablation/methods*
;
Thyroid Cancer, Papillary/surgery*
;
Thyroid Neoplasms/surgery*
;
Treatment Outcome
;
Postoperative Complications/etiology*
2.Simulation Study of Myocardial Tissue Ablation Effects Using Flower Petal-Structured Electrodes in Pulsed Ablation.
Chinese Journal of Medical Instrumentation 2025;49(2):125-133
This study aims to evaluate the application of flower petal-structured electrodes in pulsed field ablation (PFA) technology, with a particular focus on their performance in myocardial tissue ablation. Through a combination of simulation techniques and in vitro experiments, the study investigates the effects of different voltage levels, electrode-to-tissue contact distances, and their impact on ablation depth, continuity, and transmurality. The research methods include the construction of a myocardial tissue simulation model, electric field distribution simulation using COMSOL Multiphysics, and in vitro ablation experiments on potato tissue. The results indicate that as voltage increases, the ablation depth significantly increases. At a voltage of 2500 V, a transmural ablation depth of 4 mm can be achieved, and the ablation area remains relatively continuous. The in vitro experiments confirm the consistency of the simulation results, and pulsed field ablation does not induce significant temperature rise, confirming its non-thermal characteristic. The conclusion suggests that PFA technology requires less electrode contact and offers higher ablation efficiency, providing a new technological pathway for the clinical treatment of atrial fibrillation and effectively reducing the risk of complications associated with traditional ablation techniques.
Electrodes
;
Catheter Ablation/instrumentation*
;
Computer Simulation
;
Flowers
;
Atrial Fibrillation/surgery*
;
Myocardium
3.Design and Efficacy Evaluation of Steam Thermal Ablation System for Liver Tumor.
Wei WEI ; Xiaofei JIN ; Lidong XING ; Zhiyu QIAN ; Haotian WANG ; Jingqi SONG ; Kairan WAN
Chinese Journal of Medical Instrumentation 2025;49(3):323-329
To address the limitations of traditional minimally invasive thermal ablation technology such as poor conformability, carbonization and electromagnetic radiation, this paper proposes a steam thermal ablation technology that uses saturated steam internal energy to replace the traditional electromagnetic radiation energy. Through the steam thermal ablation system and the steam thermal ablation needle designed based on simulation, the ex vivo pig liver experiments were carried out. The results have the characteristics of the maximum ablation axis ratio (short diameter / long diameter) and non-carbonization with the same type of thermal ablation technology. Based on the near-infrared light, in this paper the curative effect of the reduced scattering coefficient of the steam thermal ablation results was evaluated. The reduced scattering coefficients of the coagulation area all exceeded 16, reaching the completely damaged state, which verified that the steam thermal ablation can effectively inactivate the tumor cells.
Steam
;
Animals
;
Swine
;
Liver Neoplasms/surgery*
;
Ablation Techniques/methods*
;
Liver/surgery*
;
Equipment Design
4.Advances in the treatment of retained products of conception.
Dayu YAN ; Xiangyang ZENG ; Dabao XU ; Lihui XU
Journal of Central South University(Medical Sciences) 2025;50(1):91-98
Retained products of conception (RPOC) represent a common pregnancy-related condition that may lead to complications such as abnormal uterine bleeding, infection, secondary arteriovenous fistula, intrauterine adhesions, and infertility. Currently, the main clinical treatments for RPOC include surgical intervention, medical therapy, and expectant management, sometimes supplemented by high-intensity focused ultrasound or uterine artery embolization when necessary. However, no standardized treatment guidelines exist. Medical and expectant management may help some patients avoid or reduce the need for surgery, though these approaches often involve a prolonged disease course. While surgery yields rapid results, patients with large lesions may require multiple procedures, increasing the risk of endometrial damage and intrauterine adhesions. There is still a lack of robust evidence-based guidance for selecting the optimal or individualized treatment approach. This review explores recent advances in the management of RPOC, with an emphasis on strategies that effectively preserve the endometrium, safeguard fertility, and support more precise, minimally invasive, and efficient personalized treatment.
Humans
;
Female
;
Pregnancy
;
Placenta, Retained/surgery*
;
Uterine Artery Embolization/methods*
;
Tissue Adhesions
;
Endometrium
;
High-Intensity Focused Ultrasound Ablation
5.Successful pregnancies following individualized treatment for diffuse uterine leiomyomatosis: A report of 5 cases.
Shudan CHEN ; Sili HE ; Ruizhen LI ; Chunxia CHENG
Journal of Central South University(Medical Sciences) 2025;50(6):1099-1105
OBJECTIVES:
Hysterectomy remains the only definitively effective treatment for diffuse uterine leiomyomatosis (DUL). However, no standardized management strategy exists for DUL patients wishing to preserve fertility. This study summarizes and analyzes 5 cases of individualized treatment in DUL patients desiring fertility preservation, aiming to provide a clinical reference for personalized management of similar patients.
METHODS:
We retrospectively analyzed the clinical data of 5 DUL patients with fertility intentions admitted to the Department of Obstetrics and Gynecology at Third Xiangya Hospital of Central South University. To preserve fertility, individualized treatment plans were selected based on clinical manifestations and fibroid distribution. One patient received high-intensity focused ultrasound (HIFU); one underwent hysteroscopic myomectomy (HM) combined with laparoscopic myomectomy (LRM); one underwent HIFU combined with HM and LRM; one received drug therapy combined with staged HM; and one underwent HIFU combined with staged HM and drug therapy. Treatment outcomes and pregnancy results were analyzed.
RESULTS:
After treatment, all 5 patients showed marked improvement in menstrual volume or dysmenorrhea symptoms and significant reduction in uterine volume; mild intrauterine adhesions occurred in 3 cases. All 5 patients achieved successful pregnancy. One patient with chronic hypertension developed severe preeclampsia at 34 weeks and underwent cesarean section, while the remaining 4 delivered at term by cesarean section. Three cases of placenta accreta and 2 cases of postpartum hemorrhage occurred. During long-term follow-up, one patient underwent hysterectomy 2 years postpartum due to increased menstrual volume, while the other 4 remained stable.
CONCLUSIONS
Individualized treatment tailored to DUL patients' conditions can preserve fertility, support successful pregnancy, and achieve favorable pregnancy outcomes.
Humans
;
Female
;
Pregnancy
;
Leiomyomatosis/therapy*
;
Uterine Neoplasms/therapy*
;
Adult
;
Retrospective Studies
;
Fertility Preservation/methods*
;
Hysterectomy
;
Uterine Myomectomy/methods*
;
High-Intensity Focused Ultrasound Ablation
;
Pregnancy Outcome
6.Radiofrequency ablation of inferior turbinate in the treatment of allergic rhinitis in children.
Shilei PU ; Meizhen GU ; Hongming XU ; Xiaoyan LI
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(2):114-119
Objective:To investigate the safety and efficacy of submucous radiofrequency ablation of the inferior turbinate, and to provide a clinical basis for the surgical treatment of allergic rhinitis in children. Methods:Patients with obstructive sleep apnea syndrome and allergic rhinitis who were admitted to the Department of Otolaryngology Head and Neck Surgery of Shanghai Children's Hospital from January 2021 to December 2023 and underwent bilateral submucous radiofrequency ablation of the inferior turbinate and radiofrequency ablation of the adenoid tonsil were included in the study. Observational and statistical indexes were used to evaluate the curative effect. Results:A total of 51 cases were included in this study, and 43 cases were followed up for half a year. Submucous radiofrequency ablation of the inferior turbinate plus radiofrequency ablation of the adenoid tonsil achieved a good effect (total effective rate 93%), and there was a statistically significant difference in the preoperative and postoperative symptoms of the children(P<0.05). There were no complications such as bleeding, Eustachian tube injury, nasal adhesion, or nasal dryness. Conclusion:Under the premise of strict control of surgical indications, children with allergic rhinitis can be treated surgically. Inferior turbinate submucous radiofrequency ablation is more minimally invasive, effective, and safe, and can be used in clinical practice.
Humans
;
Turbinates/surgery*
;
Rhinitis, Allergic/surgery*
;
Radiofrequency Ablation/methods*
;
Child
;
Male
;
Female
;
Sleep Apnea, Obstructive/surgery*
;
Treatment Outcome
;
Catheter Ablation
;
Adolescent
7.The management of infantile laryngeal cysts.
Fan LOU ; Cheng MING ; Yan GAO ; Jinyan ZU ; Jing MA
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(2):120-123
Objective:To explore the therapeutic strategy for laryngeal cysts in infants. Methods:A retrospective analysis of the clinical data of 19 children with laryngeal cysts treated in Kunming Children's Hospital from January 2020 to January 2023. All patients were diagnosed through electronic laryngoscopy examination. Twelve neonates were admitted to the neonatal intensive care unit. Five of them received mechanical ventilation with tracheal intubation before surgery due to severe respiratory distress, and seven received oxygen therapy with a head mask. The remaining seven children were admitted to Department of Otolaryngology Head and Neck Surgery, of which three cases were treated with oxygen therapy through a mask during sleep due to frequent shortness of breath during sleep. All patients underwent low-temperature plasma radiofrequency ablation under general anesthesia to remove the cysts. Results:Three newborns were unable to have their tracheal tubes removed due to complications with pneumonia after surgery, while the rest of the children were able to have their tubes successfully removed after complete anesthesia, and no gastric tubes were placed. All postoperative respiratory difficulties in the children disappeared, and there were no complications such as bleeding, hoarseness, or laryngeal stenosis. Five pediatric patients had incomplete relief of laryngeal ringing symptoms one month after surgery, and electronic laryngoscopy diagnosed laryngeal softening. Regular follow-up is recommended. One child relapsed 4 months after surgery and underwent a follow-up surgery six months later without recurrence. Conclusion:Endoscopic low-temperature plasma radiofrequency ablation is an effective surgical method for treating laryngeal cysts, with a low postoperative recurrence rate. Laryngeal cysts may be accompanied by laryngeal softening, which may be a possible reason for the postoperative symptoms not improving.
Humans
;
Retrospective Studies
;
Cysts/surgery*
;
Laryngeal Diseases/surgery*
;
Infant
;
Laryngoscopy
;
Infant, Newborn
;
Male
;
Female
;
Radiofrequency Ablation
8.Clinical analysis of surgical treatment and postoperative efficacy in piriform sinus fistula with acute inflammatory period of children.
Yufeng GUO ; Xingqiang GAO ; Zhengmin XU ; Haiyan DENG ; Xiaohui WU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(2):158-162
Objective:To discuss the clinical efficacy of low-temperature radiofrequency ablation assisted by endoscopy combined with resection and drainage of cervical abscess for the treatment of congenital pyriform sinus fistula (CPSF) in the acute inflammatory period of children. Methods:Clinical data of 30 patients with CPSF in the acute inflammatory period who received low-temperature radiofrequency ablation assisted by endoscopy under laryngoscope, combined with resection and drainage of cervical abscess, from January 2018 to December 2023 were reviewed. After the operation, patients were followed up closely at different stages. All patients underwent color Doppler ultrasound and electronic laryngoscopy, and the results were analyzed. Results:All 30 children successfully completed the surgery without pharyngeal fistula, dysphagia, perifistula, or distal fistula infection, and the incision in the neck healed well. The follow-up survey ranged from 6 months to 2 years, and no recurrences were observed. Conclusion:Low-temperature radiofrequency ablation assisted by endoscopy combined with resection and drainage of cervical abscess is a promising method for treating CPSF in the acute inflammatory period. It is less traumatic, simple, safe, has a significant curative effect, and a low recurrence rate. This approach can be used as a supplementary operation for CPSF in children and provides a new way for clinical treatment.
Humans
;
Pyriform Sinus/abnormalities*
;
Abscess/surgery*
;
Drainage
;
Fistula/congenital*
;
Female
;
Male
;
Child
;
Radiofrequency Ablation
;
Treatment Outcome
;
Postoperative Period
;
Endoscopy
;
Laryngoscopy
;
Inflammation
;
Child, Preschool
9.Clinical analysis of the low-temperature coblation resection of lingual thyroglossal duct cysts in children under self-retaining laryngoscope.
Weicang JI ; Haigang ZHANG ; Mingyue FAN ; Xinghe ZHAO ; Suna YANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(8):763-770
Objective:To explore the clinical efficacy of the coblation resection of lingual thyroglossal duct cysts under self-retaining laryngoscopy. Methods:A retrospective analysis was conducted on the clinical data of 22 patients with lingual thyroglossal duct cysts admitted to our hospital from December 2016 to December 2023. There were 16 males and 6 females, aged 2 years to 12 years and 3 months(mean: 4 years 1 month; median: 3 years 3 months). The lingual thyroglossal duct cysts were removed by coblation under self-retaining laryngoscopy. If the cysts could not be removed completely, the epithelial cells of the remaining cysts would be ablated. Results:There were 22 cases of lingual thyroglossal duct cysts,13 cases (59.1%) of lingual thyroglossal duct cysts had laryngeal stridor and dyspnea. The postoperative follow-up period is 3 months to 7 years. 11 cases (50.0%) underwent secondary laryngoscopic evaluation.There were 4 cases of recurrence (18.2%), with no laryngeal obstruction,bleeding, or nerve damage. Conclusion:Laryngeal stridor and dyspnea are the main clinical symptoms of lingual thyroglossal duct cysts in children. The coblation resection of lingual thyroglossal duct cysts under self-retaining laryngoscopy is safe and effective. Cyst recurrence correlates strongly with residual cyst walls, emphasizing the need for enhanced intraoperative visualization and refined surgical precision.
Humans
;
Thyroglossal Cyst/surgery*
;
Male
;
Female
;
Child
;
Retrospective Studies
;
Child, Preschool
;
Laryngoscopy/methods*
;
Treatment Outcome
;
Catheter Ablation/methods*
10.Analysis the influencing factors and risk warning of the therapeutic efficacy of multi plane low temperature plasma radiofrequency ablation for OSAHS.
Xing LIU ; Kaiwei DONG ; Meng LIU ; Huachao LI ; Bo NING
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(9):871-876
Objective:To analyze the efficacy, influencing factors, and risk warning of multi-plane low-temperature plasma radiofrequency ablation(MLT-RFA) in the treatment of obstructive sleep apnea hypopnea syndrome(OSAHS). Methods:A total of 118 OSAHS patients admitted from October 2022 to June 2024 were selected as the research subjects. They were divided into mild group(n=46), moderate group(n=52), and severe group(n=20) according to the severity of their condition. MLT-RFA treatment was used for all patients. After surgery, the results of polysomnography(PSG) and the changes in the Calier Sleep Apnea Quality of Life Index(SAQLI) were observed before and after treatment. The incidence of complications after treatment was recorded, and the clinical efficacy of the patients was evaluated. At the same time, they were divided into a treatment effective group(n=106) and an ineffective group(n=12) according to their effects. The general clinical data of the two groups were compared, and binary logistics regression analysis was conducted to identify independent factors that affect treatment efficacy and construct a model. ROC curve analysis was used to evaluate the diagnostic efficacy of the model. Results:The treatment effectiveness rate of the mild group was 93.48%, the moderate group was 90.38%, and the severe group was 80.00%. There was no statistically significant difference in the treatment effectiveness rate among the three groups(P>0.05). The AHI of the mild group, moderate group, and severe group increased sequentially, while the LSaO2and SAQLI scores decreased sequentially. After treatment, the AHI of all three groups decreased compared to before treatment, while the LSaO2and SAQLI scores increased compared to before treatment, and the differences were statistically significant(P<0.05). The pre-treatment AHI of the effective group was lower than that of the ineffective group, and the pre-treatment LSaO2and SAQLI were higher than those of the ineffective group, with statistically significant differences(P<0.05). Pre-treatment LSaO2and pre-treatment SAQLI are independent factors affecting the efficacy of MLT-RFA(P<0.05). The AUC of pre-treatment LSaO2, pre-treatment SAQLI, and combined prediction were 0.907, 0.763, and 0.947, respectively, with sensitivities of 0.896, 0.840, and 0.917, and specificities of 0.833, 0.667, and 0.887, respectively. Conclusion:MLT-RFA has a significant effect on the treatment of OSAHS, and the AHI, LSaO2, and SAQLI of patients before treatment can predict the treatment effect, with LSaO2 and SAQLI being independent influencing factors. The combinerd prediction model exhibits high diagnostic efficiency, sensitivity, and specificity.
Radiofrequency Ablation/methods*
;
Plasma Gases
;
Sleep Apnea, Obstructive/surgery*
;
Polysomnography
;
Postoperative Complications/epidemiology*
;
Quality of Life
;
Severity of Illness Index
;
Treatment Outcome
;
Humans

Result Analysis
Print
Save
E-mail